Female Sexual Health : Hormone Speciality Lab

Important hormonal milestones in any woman’s life cycle are: Puberty, Pregnancy and Menopause. Puberty and pregnancy are instrumental in defining womanhood. These hormonal events are responsible for continuation of mankind and make women biologically distinct and superior to their male counterparts.

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Truth: Diagnosis of PCOS is not that simple. At any age, diagnosis of PCOS is made only after exclusion of other diseases. These include diseases affecting other hormone producing glands like adrenals (congenital adrenal hyperplasia, Cushing syndrome), Thyroid and pituitary. Most important of these is congenital adrenal hyperplasia, which now contributes more than 12% of cases presenting with symptoms compatible with PCOS. It is pertinent to recognize and ascertain exact diagnosis in these patients as it carries great significance, especially related to outcome of future generations as this is generally inherited.

Truth: Commonly described equation, weight gain = calories consumed –calories spent, does not apply to people with PCOS. These people are somehow genetically wired to gain weight. They would have difficulty in even retaining same weight during periods of hormonal upheaval i.e. during puberty, pregnancy and even at menopause. These people need great understanding, encouragement and support from their physicians. Moreover, now more people with lean PCOS are also being diagnosed and they may, in-fact, have more severe disease.

Truth: This is biggest hoax in PCOS. Metformin is not a weight-losing drug and neither has approval from any scientific community for this use. In our clinical practice, we do see people who lose some weight on metformin but that happens only in very small minority. This does not justify treating every PCOS woman with metformin.

Medications are required to manage different manifestations of this disease. But, medications cannot cure PCOS. Only thing that can reverse or make things better in majority of patients is physical activity and weight loss. A healthy diet low in refined carbohydrates is important, as this can help regulate blood sugar levels. Exercise can also help the body regulate insulin and keep excess weight off. Losing weight is challenging with PCOS, but doing so can help reduce the male hormone levels in the body, and some women will begin to ovulate naturally.

Actually, we need to realize that lifestyle modification is required for lifetime in PCOS. Doing crash might help in short term, but physical activity in combination with a practical and pragmatic diet plan is vital for success in long term.
So, how do we suspect PCOS? If you have , especially with family background of diabetes, two or more of the following symptoms, you need to have a thorough checkup to determine if you need PCOS treatment:
- Irregular or missing menstrual periods
- Infertility
- Excess or unwanted body or facial hair growth
- Thinning hair on the scalp
- Weight problems, often including weight gain around the waist
- Skin problems, including skin tags, darkening skin and acne
With a proper diagnosis, lifestyle changes and PCOS treatment, women can get relief from this condition and the overwhelming health problems it can cause.

Menopause is an important milestone in any woman’s health cycle. Female hormones viz. estrogens and progesterone are responsible for maintaining cyclical menstrual bleeding and thus fertility in women. These hormones, especially estrogen, have been shown to have a tremendous positive impact on health of other organs like bones, heart and brain. At menopause, secretion of these hormones gets halted. This predisposes the women towards poor health outcome in form of disruption in sex life, osteoporosis (weak bones), heart problems and also increased risk of dementia (decreased thinking power).

Menopause is a normal physiological event in any woman’s life. In view of positive impact of female hormones on all body function, there had been a great enthusiasm towards treating every woman with these hormones in past. But, recent studies have suggested that benefit of this treatment is not uniform and great and may even harm woman. But, this does not mean that a woman with menopausal symptoms have to suffer. We have safe and established treatments to alleviate these symptoms and thus improving quality of life during menopausal transition. Even hormonal replacement for short term periods has been shown to be safe. But, individualization of treatment is of paramount importance in management.

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